Invite ye felawes and frendes desirous in gold to enter the gates of Shrewd'm, for they will thanke ye later.
- Manlobbi
Stocks A to Z / Stocks C / Costco (COST)
No. of Recommendations: 3
This bears watching:
SNIP A top prosecutor suggested on Thursday that the total amount of fraud in Minnesota could be $9 billion or more.
According to First Assistant U.S. Attorney Joe Thompson, 14 Medicaid services under audit and deemed "high risk" for fraud have cost the state $18 billion since 2018.
Thompson said a substantial amount of money billed across those programs is fraudulent, but the exact amount is still under investigation.
"I don't make these generalizations in a hasty way," he said. "When I say significant amount, I'm talking on the order of half or more. But we'll see. When I look at the claims data and the providers, I see more red flags than I see legitimate providers."...
..."The magnitude cannot be overstated," Thompson said. "What we see in Minnesota is not a handful of bad actors committing crimes. It's staggering, industrial-scale fraud." SNIP
https://www.cbsnews.com/news/billions-paid-out-by-...
No. of Recommendations: 4
OMG this dude must be a total racist Nazi just like Trump. How dare he accuse the Somalis community of fraud! They're just poor refugees trying to make a better life for themselves!
It's all the fault of white people
No. of Recommendations: 6
If you read that, there's more red flags than legitimate, and the word was out - people from out of state were defrauding, there was sl little oversight. All the states need to tighten up and put in safeguards, but it's the perfect time to get convicted at the federal level for stealing 100 million, you can bribe Trump with 5 mill and get a pardon.
No. of Recommendations: 1
Ug. From the article:
The investigators' new findings may bolster President Trump in his claims that Minnesota is a "hub of fraudulent money laundering activity" under Gov. Tim Walz, who was the Democrats' vice presidential nominee in last year's presidential election.
Trump has capitalized on the fraud cases to target the Somali diaspora in Minnesota, calling them "garbage" and saying he doesn't want immigrants from the East African country in the U.S.
More than 90% of the people charged in the major fraud cases announced before today were of Somali descent, according to the U.S. Attorney's Office for Minnesota.
More ammunition for Trump and friends to attack Walz and all people originating in "sh!t hole countries".
So, how much did Walz know and when did he know it? Or can something this huge have flown below his radar?
No. of Recommendations: 5
The Trump DOJ is very successful in trying cases in the court of public opinion. They have fallen quite short of success in actual courtrooms. I'll wait for cases to actually be taken before a judge and jury.
No. of Recommendations: 4
So, how much did Walz know and when did he know it? Or can something this huge have flown below his radar?
It looks like he knew about the fraud in the Child Nutrition programs, but not the rest, so this hurts him badly, may be fatal. It's gonna hurt the innocent among the Somalians, because everyone in Minnesota will follow this. I'm interested in how big it is, who the perps are, and if it starts getting caught in other states. They stole enough they can easily bribe Trump at the Federal level, and from outside of the country.
No. of Recommendations: 5
The Trump DOJ is very successful in trying cases in the court of public opinion. They have fallen quite short of success in actual courtrooms. I'll wait for cases to actually be taken before a judge and jury. How short? Umm. That's why I said to keep an eye on it. But, my spidy sense there's quite a bit there, the criminal types were talking to each other about it.
Minneapolis woman pleads guilty in $250 million Feeding Our Future fraud scheme
Date: Feb. 25, 2025 Contact: newsroom@ci.irs.gov
MINNEAPOLIS — A Minneapolis woman has pleaded guilty for her role in the $250 million fraud scheme that exploited a federally funded child nutrition program during the COVID-19 pandemic, announced Acting U.S. Attorney Lisa D. Kirkpatrick.
According to court documents, Najmo M. Ahmed helped her husband Said Ereg run a small storefront grocery store in Minneapolis called Evergreen Grocery and Deli. In April 2020, Ereg enrolled Evergreen Grocery and Deli in the Federal Child Nutrition Program as a food distribution site under the sponsorship of Feeding Our Future. Under the direction of her husband, Ahmed signed falsified meal count sheets, including one dated Dec. 31, 2020, claiming Evergreen Grocery and Deli served 3,250 children – twice a day – during the week of Jan. 24, 2021. Between April 2020 and April 2021, Evergreen Grocery and Deli claimed to have served over 1.4 million meals to children.
https://www.irs.gov/compliance/criminal-investigat...Federal prosecutors charge six more people in ‘staggering’ social services fraud scandal
Those charged Thursday reportedly scammed more than $11.6 million from housing stabilization and autism services programs.
By Jessie Van Berkel
The Minnesota Star Tribune
https://www.startribune.com/federal-prosecutors-ch...
No. of Recommendations: 1
As outrageous as the fraud is, what are the chances his nibs will use this cluster of cases the same way he leverages a handful of immigrant murderers/sex perverts, to shut down the entire program?
After all, poor people have agency, right? They can always work more jobs/more hours, to make up for the lack of government support, right? Then the money can go where it is really needed, to the rich, right?
/sarcasm
Steve
No. of Recommendations: 4
How much did the scammers contribute to the Democrat Party, politicians, or affiliated PACS and NGOS?
There's your answer.
No. of Recommendations: 14
How dare he accuse the Somalis community of fraud!
You’ve accidentally put your finger on the issue that divides honest reporting from hate mongering, racist propaganda.
And still, you fail to see what that difference is, but the glaring answer is right there in the words you chose to use.
No. of Recommendations: 4
libs far and wide sneer when somebody notes that government programs are rife with fraud.
Over HALF of Medicare in Minnesota is fraudulent. OVER HALF.
All the single payer advocates on this board will memory-hole this as fast as they can.
No. of Recommendations: 5
As outrageous as the fraud is, what are the chances his nibs will use this cluster of cases the same way he leverages a handful of immigrant murderers/sex perverts, to shut down the entire program?
Pretty good chance because he always needs a distraction, right? So he shuts down programs, hatemongering along the way, and in the end maybe there's 1 billion in fraud found, a chunk isn't Somali, and if any are convicted, he's selling pardons. What a country!
No. of Recommendations: 1
All the single payer advocates on this board will memory-hole this as fast as they can. I have wondered how the French system reduces fraud.
Of course, the "big gummit" programs are not the only ones that are defrauded.
from the net sifter:
US private health insurers lose billions to fraud annually, with estimates varying widely, but figures often fall in the tens of billions to over $100 billion, with some sources suggesting it could reach $240 billion annually, though exact figures are elusive, with a significant portion of overall healthcare fraud (potentially over $300 billion total) impacting private plans. These losses are driven by provider overbilling, false claims, and patient fraud, ultimately increasing premiums for everyone.
Key Figures & Estimates:
General Healthcare Fraud: Estimates for total U.S. healthcare fraud (including Medicare/Medicaid) range from $100 billion to over $300 billion annually.
Private Health Insurance: One analysis suggests private insurers might lose around $240 billion annually if 20% of their spending is fraudulent.
The NC Department of Insurance cites estimates placing private health insurance fraud at $36.3 billion annually, part of a larger $105 billion total for public and private health insurance fraud.
Provider Fraud: A significant chunk involves providers billing for unrendered services or upcoding (billing for more complex services than provided)Fraud is a growth industry in Shinyland. Some of us remember when Tenet Healthcare's core business model was cheating Medicare.
Hospital Chain Will Pay over $513 Million for Defrauding the United States and Making Illegal Payments in Exchange for Patient Referrals; Two Subsidiaries Agree to Plead Guilty
A major U.S. hospital chain, Tenet Healthcare Corporation, and two of its Atlanta-area subsidiaries will pay over $513 million to resolve criminal charges and civil claims relating to a scheme to defraud the United States and to pay kickbacks in exchange for patient referrals. https://www.justice.gov/archives/opa/pr/hospital-c...SEC Charges Tenet Healthcare Corporation and Four Former Senior Executives With Concealing Scheme to Meet Earnings Targets by Exploiting Medicare System
Washington, D.C., April 2, 2007 — The Securities and Exchange Commission today filed civil fraud charges in federal district court against Tenet Healthcare Corporation and its former chief financial officer and co-president, its former chief operating officer and co-president, its former general counsel and chief compliance officer, and its former chief accounting officer for failing to disclose to investors that Tenet's strong earnings growth from 1999 to 2002 was driven largely by its exploitation of a loophole in the Medicare reimbursement system. Once Tenet finally revealed its scheme to the investing public and admitted that its strategy was not sustainable, the market value of Tenet's stock plunged by over $11 billion.https://www.sec.gov/news/press/2007/2007-60.htmPrivate insurance companies are often bilked as well, in spite of the obstacles they throw up, impeding legitimate claims. They don't want to admit how much they lose, because it would upset shareholders at their breakfast.
Steve
No. of Recommendations: 8
Over HALF of Medicare in Minnesota is fraudulent. OVER HALF.
You are 16,000% wrong. For a prosecutor, a "red flag" isn't just one thing, but rather
indicators of potential criminal activity, weak cases, or unethical behavior
So Thompson said this: "When I look at the claims data and the providers, I see more red flags than I see legitimate providers."...
Now anyone who has done this knows that a red flag can disappear quickly, but some of them you work on for a month or more and then they disappear. He's saying he's looking at claims data and providers, but if he had established that half weren't legitimate providers, he wouldn't be talking red flags. He'd be saying half of the claims he's looking at are from known illegitimate providers - and he isn't saying that, he's talking red flags. That means he's just looked at a printout and guessed that they are illegitimate providers. (Some probably are.) Now why would he do that? He's a political animal of course.
Well, he's got 250 million from verdicts, and charged another 11 million, so he's got 8.74 billion more to go to get to 9 billion. Let's see what happens.
No. of Recommendations: 1
Hat tip to any and all that got you people for money.
Don't knock it till you've done it.
How many figures can it be done for?
:)
And can TMF boards be quietly used to do it also?
:)
Glad them posts are gone ......
No. of Recommendations: 3
https://www.cbsnews.com/minnesota/news/billions-pa...At least $9B billed across 14 Medicaid services in Minnesota may be fraudulent, top prosecutor says
Updated on: December 18, 2025 / 7:22 PM CST / CBS/AP
Add CBS News on Google
A top prosecutor suggested on Thursday that the total amount of fraud in Minnesota could be $9 billion or more.
According to First Assistant U.S. Attorney Joe Thompson, 14 Medicaid services under audit and deemed "high risk" for fraud have cost the state $18 billion since 2018.
Thompson said a substantial amount of money billed across those programs is fraudulent, but the exact amount is still under investigation.
"I don't make these generalizations in a hasty way," he said. "When I say significant amount, I'm talking on the order of half or more. But we'll see. When I look at the claims data and the providers, I see more red flags than I see legitimate providers."
No. of Recommendations: 4
All the single payer advocates on this board will memory-hole this as fast as they can.
Dope brought up a good point. So I asked the net sifter for some numbers.
US health insurance losses to fraud:
U.S. health insurance fraud costs are massive and vary by estimate, ranging from
over $100 billion (combining private, Medicare, Medicaid losses) up to potentially $300 billion or more annually, with some studies showing Medicare/Medicaid alone at $105 billion and private insurers facing huge losses from fraud, waste, and abuse, all contributing to higher premiums and healthcare costs for everyone
$300B, for a population of 343M. $875/person
France:
France's National Health Insurance (CNAM) detects millions in fraud, reaching a record €315 million in 2022, but estimates for total annual losses due to broader "social fraud," including healthcare overbilling, range much higher, with some sources suggesting up to €8 billion, though these figures vary and capture different aspects of fraud, from individual misuse to provider schemes
8B Euros, for a population of 68.6M, or 116 Euros or $136 US/person.
UK:
The UK's National Health Service (NHS) loses over £1.2 billion annually to fraud, with estimates around £1.3 billion or more, impacting patient care by diverting funds for essential services like staff, ambulances, or treatments. This isn't actual identified loss but rather the potential vulnerability, covering crimes by patients (e.g., free prescriptions), staff, contractors (dentists, pharmacists), and procurement issues, with the NHS Counter Fraud Authority (NHSCFA) leading the fight against it
1.3BGBP, for a population of 69M, 18.84GBP, or $25.22 USD/person
In the French, and, to a greater degree in the UK system, most hospitals are directly owned by the national health system, while most GPs own their practices.
Again, if anyone has other numbers, please bring them to the discussion....and check my math. Math and I were never friends.
Steve
No. of Recommendations: 1
I have wondered how the French system reduces fraud.
Ask the net sifter. :)
Just remember, France is a little smaller than Texas, is 600 miles wide, and has ~70 million people. The US is as big as Europe up to the Russian border,is 2800 miles wide, and has 347 million people.
No. of Recommendations: 4
U.S. health insurance fraud costs are massive and vary by estimate, ranging from
over $100 billion (combining private, Medicare, Medicaid losses) up to potentially $300 billion or more annually, with some studies showing Medicare/Medicaid alone at $105 billion and private insurers facing huge losses from fraud, waste, and abuse, all contributing to higher premiums and healthcare costs for everyone
$300B, for a population of 343M. $875/person
Given how scarce medical resources are, stuff like this ought to be resulting in people serving prison sentences.
No. of Recommendations: 4
Why do fools like you insist on speaking in riddles?
You think it shows you to be a wise man.
Nope. You're just confused.
No. of Recommendations: 3
Yeah and how much of the fraud is committed by Democrats, for Democrats, at the behest of Democrats?
Lotsa.
No. of Recommendations: 3
At least $9B billed across 14 Medicaid services in Minnesota may be fraudulent, top prosecutor says
Key word here is may. That was absent in your declaration. Everything you posted there is in the article I posted.
No. of Recommendations: 16
Dope
Given how scarce medical resources are, stuff like this ought to be resulting in people serving prison sentences. I agree. Seems US medical fraudsters are using the same playbook as financial fraudsters,
if they have size. The company pays Millions to settle the case, but the honchos on whose watch the fraud was committed walk free, with their 8 figure paydays. A crooked oncologist here in metro Detroit, was running his fraud on his own, and he's doing hard time. This creep defrauded Medicare and private insurance companies alike.
Farid Tanios Fata (Arabic: فريد طانيوس فتى, born 1965) is a Lebanese-born former hematologist/oncologist and the mastermind of one of the largest health care frauds in U.S. history. Fata was the owner of Michigan Hematology-Oncology (MHO), one of the largest cancer practices in Michigan. He was arrested in 2013 on charges of prescribing chemotherapy to patients who were healthy or whose condition did not warrant chemotherapy, then submitting $34 million in fraudulent charges to Medicare and private health insurance companies over a period of at least six years.
Fata pleaded guilty in 2014 to charges of health care fraud, conspiring to pay and receive kickbacks, and money laundering. On July 10, 2015, he was sentenced to 45 years in federal prisonhttps://en.wikipedia.org/wiki/Farid_FataMarco
Yeah and how much of the fraud is committed by Democrats, for Democrats, at the behest of Democrats?There are plenty of money grubbing fraudsters on both sides of the aisle.
Remember HCA, Healthcare Corporation of America?
US settles biggest ever healthcare fraud case
HCA admitted to a long list of charges, including submitting inflated bills and expenses to the government for payment; exaggerating the seriousness of diagnoses to increase Medicare reimbursement; illegally structuring business deals so that Medicare picked up the cost of corporate expenses; and providing doctors with kickbacks for patient referrals.
HCA also gave other inducements to win favour from doctors, such as free rent and office refurbishment and free drugs from hospital pharmacies. One of HCA's most controversial business practices involved providing partnership investments in company hospitals for doctors, who could then refer patients to them. The programme was abandoned in 1997 when Thomas Frist Jr, the brother of US Republican Senator Bill Frist of Tennessee, took over as chief executive from Richard L Scott, the founder of Columbia/HCA.https://pmc.ncbi.nlm.nih.gov/articles/PMC1119297/Scott and Bill Frist are both Republicans. Scott, founder of Columbia was Governor of Florida from 2011 to 2019, and Senator from Florida since 2019, all after his fraudulent activities at Columbia/HCA were known. Frist, whose family members founded HCA, was a Senator representing Tennessee from 1995-2007.
Steve
No. of Recommendations: 2
All the single payer advocates on this board will memory-hole this as fast as they can.
Umm. I brought up the article and posted the 9 billion potential fraud, say it bears watching, and I advocate for a single payer system, among others, etc. So you're saying I'm going to forget something that I posted and said we should keep a watch on?
No. of Recommendations: 3
I brought up the article and posted the 9 billion potential fraud, say it bears watching, and I advocate for a single payer system, among others, etc. So you're saying I'm going to forget something that I posted and said we should keep a watch on?
Probably, yes.
Whenever the subject of waste in government is brought up libruls often scoff and sneer. What will I find if I go hunting for posts on DOGE from this board?
Will those posts be:
a) Thoughtful posts on the legit reasons to look for waste, fraud and abuse in a government the size of ours and that doing so is a good thing, -or-
b) Sneering contempt for the entire exercise and anyone who supports it
Which? Consider this an integrity test.
No. of Recommendations: 2
All the single payer advocates on this board will memory-hole this as fast as they can.
Dope brought up a good point. So I asked the net sifter for some numbers.
I don't think him saying I'll memory hole what I just posted and said bears watching is a good point.
$300B, for a population of 343M. $875/person
I'd take the midpoint of 200B at $583. But I think your math is fine.
Nefster: "While pinpointing an exact figure is difficult, estimates from various U.S. government agencies and industry organizations suggest that 3% to 10% of total annual healthcare expenditures in the USA are lost to fraud. Given that U.S. healthcare spending reached approximately $4.9 trillion in 2023, this range translates to a potential loss of anywhere from roughly $147 billion to $490 billion annually. "
3-5% is acceptable, but 10% is not.
I agree people should be going to jail.
Nefster: When individuals are convicted of healthcare fraud in the USA, they often go to jail. Approximately
70% to 75% of those convicted are sentenced to prison, with an average sentence of around 27 to 30 months.
No. of Recommendations: 3
Probably, yes.
Then go fuck yourself.
Whenever the subject of waste in government is brought up libruls often scoff and sneer.
No, it's the way you bring it up. Witness me posting about about a potential 9 billion in fraud and you telling me we ignore it and I'll likely forget it. Again, go fuck yourself for that.
What will I find if I go hunting for posts on DOGE from this board?
I only know me, and I would've said you won't find much fraud using his method of Ivory Towering it from the top. But I was ready to be wrong, there could be something outside of my experience. You gotta have intelligent qualified folks go out there and really go through the books and records and talk to people.
Will those posts be:
a) Thoughtful posts on the legit reasons to look for waste, fraud and abuse in a government the size of ours and that doing so is a good thing, -or-
Me? The reason why they didn't find much is the method they used. But don't forget, because of the way you approach it, you invite sneering and contempt. I mean you just told me that I'm going to forget about a post I made and said bears watching. What kind of asshat does that?
b) Sneering contempt for the entire exercise and anyone who supports it
Which? Consider this an integrity test.
You shouldn't consider it an integrity test. It's actually too bad it didn't work to some good degree. But it's horrific to find hard working people tossed out of their jobs because Elon can't find fraud. I saw Elon's NAZI salute and lost respect for the guy.
No. of Recommendations: 4
Then go fuck yourself.
Oooo. Touchy this holiday season.
No, it's the way you bring it up.
Lulz. Sounds like a 'you' problem, not a 'me' problem.
Me? The reason why they didn't find much is the method they used. But don't forget, because of the way you approach it, you invite sneering and contempt. I mean you just told me that I'm going to forget about a post I made and said bears watching. What kind of asshat does that?
HAHAHAHAAHAHAHAHAHAHAHAHAA. This is funny. For one, the performative drama here is far less than what your board peers normally put on.
For two, you people drop insults and poop all over the board because you're who you are. Are you an adult? Evidently not, if you just HAVE to respond with "Go f yourself" because "of the way [other posters] approach it". Way to have agency over your Tourette's-like outbursts.
As for me, I take it easy on you people.
You shouldn't consider it an integrity test.
You get half a point. I should have phrased it as a reality check. Either way, you failed it.
No. of Recommendations: 5
Ormont found this over here
https://www.shrewdm.com/MB?pid=42930968“A guy just used @AnthropicAI Claude to turn a $195,000 hospital bill into $33,000.
Not with a lawyer. Not with a hospital admin insider. With a $20/month Claude Plus subscription. He uploaded the itemized bill. Claude spotted duplicate procedure codes, illegal “double billing,” and charges that Medicare rules explicitly forbid. Then it helped him write a letter citing every violation. The hospital dropped their demand by 83%. This isn’t just a feel-good story. It’s a preview of what AI will really do next: flatten systems built on opacity. Hospitals, insurance companies, legal firms—all rely on asymmetry. They win because you don’t have access to the same data, code books, or language. Claude gave one person the same leverage as a compliance department. That’s a revolution. We thought AI would replace jobs. Turns out, it’s replacing excuses.”
https://humbledollar.com/forum/patient-uses-ai-to-...I was talking about this potential yesterday, and it's already here and in use. I'm amazed by what you can do with AI. We can probably train AI to look for red flags and make it more difficult to defraud the system too. And it can be used the other way to make fraud harder to detect. Ah Well, I can see I'm waaay behind on this AI stuff.
No. of Recommendations: 2
It’s a preview of what AI will really do next: flatten systems built on opacity. Hospitals, insurance companies, legal firms—all rely on asymmetry.
In the thread about administrative overhead, I started wondering about the potential for AI to reduce the excessive manning in the US healthcare industry. But then, I thought, all that paper shuffling gives insurance companies an excuse to not pay claims for weeks or months. Time has it's own value to companies.
Steve
No. of Recommendations: 2
that paper shuffling gives insurance companies an excuse to not pay claims for weeks or months.
You just delay with less people, you can always delay. One companies formula was to always initially deny any claim, because a certain number of people would accept that. But if you are defrauding, you just have AI make minor changes and resubmit. At first we'll be looking for the claim with five fingers, then immediately everything from that provider becomes suspect. A lot of the fraud will be additional codes or coding up. I'm suspicious of my CPAP supply provider because I periodically see rental charges and it's been over two years.
